We get a lot of questions about Long Term Care Insurance (LTC Insurance).  It’s no surprise; understanding insurance of any kind can seem daunting. That’s why we’d like to take the mystery out of LTC Insurance and answer some of the most common questions we receive. Grab a cup of coffee—or whatever beverage you fancy—and read on.

Frequently Asked Questions About LTC Insurance

1. Why do I need it?
2. When I have it, when can I use it?
3. How can I use it?
4. Can I Stay at Home and Receive LTC Insurance benefits?
5. How does reimbursement work on LTC Insurance plans?
6. What is the ideal age to invest in LTC Insurance?

#1 Why Do I Need It?

We have insurance for our cars, our homes, even our pets. People are living longer, so the probability of needing Long Term Care Insurance is very likely. Why wouldn’t we want to prepare for a time in our lives when the benefit of assisted care will be most needed?  “When developing a retirement strategy, it is important to plan for the expected and prepare for the unexpected.” Edward Jones

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#2 When I have it, when can I use it?

Although all policies are slightly different, insurance companies use Activities of Daily Living (ADLs) to measure an individual’s level of functioning and, in turn, determine whether benefits should commence. There are six generally recognized ADLs:

1. Bathing
2. Dressing
3. Eating
4. Transferring – Being able to either walk or move oneself from a bed to a wheelchair and back again.
5. Toileting – The ability to get on and off the toilet.
6. Continence – The ability to control one’s bladder and bowel functions.

Needing assistance with two or more ADLs will typically be the trigger to qualify for benefits. Most policies carry an exemption period ranging from 0 to 120 days that is selected when choosing a plan. During the exemption period the insured is responsible for the cost of care out-of-pocket until the exemption period is over.

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#3 How Can I Use It?

Find a provider, like Silver Lining Home Healthcare, that takes LTC Insurance. Here are some resources to help you:

• Delaware Aging & Disability Resource Center – The Delaware Office of Health Licensing and Certification oversees all licensed facilities/companies in Delaware. If you don’t live in Delaware, search and see if you have a licensing/overseeing body.
• For a list of skilled licensed agencies in Delaware, visit Delaware Health and Social Services.
• Caring.com  – A resource site offering a vast amount of information pertaining to senior care. Find services across the country, connect with a support group, or read reviews of agencies.
• For an understanding of the different types of home care licensure, watch our video, What Is Home Care?
• To help you compare providers, use our downloadable list of questions: Researching Home Care Options: What to Look For.

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#5 How Does Reimbursement Work on LTC Insurance Plans?

At Silver Lining Home Healthcare, we’ve streamlined the process for our clients. A client simply submits the initial claim and afterward, we submit all documentation and invoicing monthly on their behalf. Our client pays us and is reimbursed by their insurance company.

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#6 What Is the Ideal Age to Invest in LTC Insurance?

While everyone’s circumstances are different, usually the best time to buy LTC Insurance is in your mid-50s. Consulting with a financial advisor is the best first step you can take in determining what is right for you and your circumstances. Christopher Smith of Edward Jones in Dover, DE is a local Certified Financial Planner who helps individuals with questions like this. His focus areas include Saving for Retirement and Insurance Needs. You can “virtually” meet Chris here: Christopher Smith, CFP®, AAMS®

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“A Woman’s Perspective on Long-term Care”– Edward Jones

Our talent is caring,

Tiffany Rubin, CEO

Silver Lining Home Healthcare

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